Fear of violence increases risk behaviours of persons living with HIV (PLHIV) in Guyana

OBJECTIVE: To assess if fear of violence among PLHIV in Guyana affects sexual risk behaviours. DESIGN AND METHODS: In 2011 a cross sectional survey was conducted of the sexual risk behaviours of 271 PLHIV enrolled in a Prevention with Positives (PwP) project promoting risk reduction behaviours at seven non-governmental organizations (NGOs). Quantitative data was analyzed using STATA. Seventeen PLHIV and partners were interviewed using a semi-structured guide. Transcripts were analyzed for themes and data triangulated to understand the prevalence of risk behaviours and the barriers to risk reduction among PLHIV. RESULTS: Domestic violence was experienced by 25.9% of enrollees. HIV positive women were more likely to have fears of violence (OR, 3.6; 95% CI 0.58, 5.48) and to be in a sexual relationship with an HIV negative partner (OR 4.1; 95% CI 0.5, 49.4) than males though these were not statistically significant when adjusted for disclosure and having sex for things. PLHIV who were not afraid of violence were more likely to disclose (P=0.03 Fisher exact). When controlling for gender, having sex for things, and HIV status of partner, PLHIV who were not afraid of violence were significantly more likely to use family planning (OR= 10.7: 95% CI 1.9, 61.4). HIV positive women experienced discrimination when seeking social services. CONCLUSIONS: Fear of violence was a barrier to disclosure and use of family planning. Gender differences in experiences of violence should be catered for and discrimination against PLHIV by staff at social services addressed.

A dose-response analysis of skin cancer from inorganic arsenic in drinking water.

A study of the prevalence of skin cancer among 40,421 persons consuming arsenic-contaminated drinking water in Taiwan was used for a cancer dose-response assessment of ingested arsenic. The numbers of persons at risk over three dose intervals and four exposure durations were estimated from the data in order to apply the method of maximum likelihood to a multistage-Weibull time/dose-response model. A constant exposure level since birth for each of the exposure categories was assumed. It was found that the cumulative hazard increases as a power of three in age, and is linear or quadratic (with a linear coefficient) in dose. Observations from a smaller epidemiologic survey in Mexico were similar to what would be predicted from the model of the Taiwan data. Assuming that the skin cancer risk from ingested arsenic in the American population would also be similar to the Taiwan population, an American male would have a lifetime risk of developing skin cancer of 1.3 x 10(-3) (3.0 x 10(-3] if exposed to 1 microgram/kg/day for a 76-year lifespan (median lifespan in the U.S.).